Periodontal disease is a disease wherein soft tissue around teeth, and alveolar bone are destroyed by chronic inflammation caused by periodontal pathogens, so that the gum bleeds and teeth are loose and ultimately lost. Periodontal pathogens include Prevotella intermedia, Actinomyces israelii, Fusobacterium nucleatum, etc.
Efforts have been made to eliminate plaque-forming bacteria using antibiotics such as penicillin in order to prevent periodontal disease. However, these antibiotics are not used in clinical practice, because antibiotic-resistant bacteria are created when these antibiotics are used for a long period of time. To overcome this advantage, various methods comprising the use of fluorine-based compounds or automatic dental cleaning devices have been developed, but the effects thereof are insignificant.
A connective tissue attachment to normal periodontal tissue is composed of extracellular matrix complexes, such as the fibroblasts of gingival and periodontal ligaments, gingival epithelial cells, vascular endothelial cells, neurites, alveolar periodontal bone, collagen, glycoprotein, and proteoglycan. Periodontally diseased root surfaces can act as suitable matrices for loss of connective tissue attachment, loss of alveolar bone, contamination of the tooth root with bacteria and bacterial endotoxins, the change in the density and content of minerals, cell adhesion, and fibril development, thus causing pathological changes such as loss of chemotaxis to the required progenitor cells.
Thus, in order for regeneration of the tissue destroyed by periodontal disease, the environment of a root surface should be changed so that connective tissue cells can migrate and adhere to the root surface. Mechanical methods for treating the root surface include scaling and root planing.
However, a smear layer can be formed on the root surface after mechanical cleaning and can serve as a matrix, which can inhibit fibroblast attachment and connective tissue attachment and in which bacteria can grow, thus interfering with the healing of periodontal tissue. For this reason, methods have been conducted on methods of treating the tooth root using a tooth root cleaner. Dental cleansers (tooth root cleaners) are used to remove minerals from the root surface and to remove toxic substances induced by bacterial products.
Agents for cleaning the root surface, which have been studied, include citric acid, fibronectin, tetracycline hydrochloride (Tc-HCl), phosphoric acid, stannous fluoride, ethylene diamine tetraacetic acid (EDTA), chlorhexidine, formalin, cetylpyridinium chloride, sodium-N-lauroyl sarcosine, zinc iontophoresis, and the like.
Korean Patent Registration No. 621,191 (entitled “tooth cleaning composition containing polylysine”) and Korean Patent Laid-Open publication No. 2007-0103761 (entitled “anti-corrosive cleaner composition and use thereof for cleaning of dental and medical devices”) disclose that the use of acidic chemical agents, such as citric acid, tetracycline-HCl, in many animal tests, has positive effects on the regeneration of periodontal tissue, including effects on the removal of a smear layer, the opening of dentinal tubules, the exposure of a collagen matrix by decalcification of intertubular dentin, the removal of endotoxin, and antibacterial activity.
However, a series of clinical studies reported that these chemical substances did not show a significant improvement, and could result in tooth root resorption, bony ankylosis, tissue necrosis and gingival recession during a healing process, and could interfere with the restoration of alveolar bone. Thus, there has been a need to develop other methods for treating the root surface, which can promote the healing of connective tissue.
Accordingly, the present inventors have made extensive efforts to solve the above-described problems occurring in the prior art and, as a result, have found that a composition comprising the nonionic surfactant octyl phenol ethoxylate and sodium ethylene diaminotetraacetate functions removes not only a smear layer from the tooth root, but also oral bacteria and lipopolysacchride, and thus improves adhesion to teeth in periodontal surgery, thereby completing the present invention.